A Pilot Study of Seeking Safety Therapy with OEF/OIF Veterans

Abstract

PTSD and substance use disorder (SUD) are highly prevalent among Veterans returning from Iraq and Afghanistan (Operation Enduring Freedom/Operation Iraqi Freedom; OEF/OIF). Seeking Safety (SS) is a cognitive-behavioral psychotherapy for co-occurring PTSD/SUD. This pilot study with fourteen male OEF/OIF Veterans suggests that SS may help to reduce alcohol use, PTSD, and depression in some participants at clinically significant levels, even when providing less than half of the full model. We emphasize several SS features as especially helpful: the case management component to help engage clients in further mental health and SUD care; offering PTSD as an entry point, and emphasis on community resources. Issues particular to Veterans include reintegration to civilian life and supporting Veterans' connection with other Veterans.

Psychotherapy for military-related posttraumatic stress disorder: Review of the evidence

“…We first review clinical outcome studies that target PTSD in veterans and active duty personnel, then review the real-world clinical implementation of these treatments within the DoD and VA, and end with considerations for future research. The scope of this paper is limited to individual outpatient psychotherapy, although couples (e.g., Fredman, Monson, & Adair, 2011), family (e.g., Glynn et al, 1999), group (e.g., Norman, Wilkins, Tapert, Lang, & Najavits, 2010), inpatient/residential (e.g., Alvarez et al, 2011), and web-based (e.g., Litz, Engel, Bryant, & Papa, 2007) psychotherapies for military-related PTSD are also available and represent important additional sources of patient care.…”

The Effectiveness of Seeking Safety on Reducing PTSD Symptoms in Clients Receiving Substance Dependence Treatment

“…Furthermore, five of the nine (62.5%) participants had marked decreases in depression scores, and five out of the nine (62.5%) participants decreased their number of drinking days, the number of drinks consumed per drinking event, or both (Norman et al, 2010).…”

“…SS has been studied with many different populations including female prisoners (Zlotnick et al, 2009;Zlotnick et al, 2003), adolescent females (Najavits, Gallop, & Weiss, 2006), females in community treatment (Brown et al, 2007;Grupp, 2008;Hien et al, 2009;Najavits, Weiss, et al, 1998), and male and female Veterans (Cook, Walser, Kane, Ruzek, & Woody, 2006;Norman et al, 2010). Study designs range from multisite randomized controlled trials (RCTs; e.g., Hien et al, 2009) to uncontrolled pilot studies with very small samples (Najavits, Schmitz, Gotthardt, & Weiss, 2005).…”

“…Studies find that large percentages of men and women in substance abuse treatment (Hien, Cohen, Miele, Litt, & Capstick, 2004), prisons (Heath, 2010;Zlotnick, Johnson, & Najavits, 2009;Zlotnick, Najavits, Rohsenow, & Johnson, 2003), psychiatric hospitals (Brown, Stout, & Mueller, 1999), and Veteran's hospitals (Norman, Wilkins, Tapert, Lang, & Najavits, 2010) have co-occurring substance use disorders (SUD) and posttraumatic stress disorder (PTSD). Zlotnick et al (2009) reported that the rate of incarcerated women, exhibiting PTSD and SUD symptoms, is rising.…”

Trauma et usage problématique de substances chez les jeunes : synthèse des travaux de recherche sur le programme Seeking Safety et projet pilote

“…Disponible sous forme de manuel de traitement, le programme SS est le premier traitement ÉSPT-TUS pour lequel des résultats positifs ont été rapportés (Hien et al, 2004 ;Najavits, 2003). Il est aujourd'hui empiriquement validé aux États-Unis pour les anglophones et plusieurs études ont été réalisées sur des populations variées : des femmes incarcérées (Lynch, Heath, Matthews & Cepeda, 2012 ;Zlotnick, Johnson & Najavits, 2009 ;Zlotnick et al, 2003), des femmes provenant de milieux défavorisés (Cohen & Hien, 2006 ;Hien et al, 2004), des hommes et femmes vétérant(e) s de l'armée (Boden et al, 2011 ;Cook, Walser, Kane, Ruzek & Woody, 2006 ;Desai, Harpaz-Rotem, Najavits & Rosenheck, 2009 ;Desai, Harpaz-Rotem, Najavits & Rosenheck, 2008 ;Norman, Wilkins, Tapert, Lang & Najavits, 2010 ;Weaver, Trafton, Walser & Kimerling, 2007 ;Weller, 2005) et des patients en clinique ambulatoires (Najavits, Schmitz, Gotthardt & Weiss, 2005 ;Najavits, Weiss, Shaw & Muenz, 1998).…”